We studied the effect of acupuncture in 49 patients with angina pectoris with focus on its relationship to psycho-social factors and changes in skin tempeature, pain thresholds, and pain tolerance thresholds. No significant influence from patient expectation, social stress (strain) or profiles of the Minnesota Multiphasic Personality Inventory (MMPI) was found (all p > 0.1). Acupuncture slightly increased exercise tolerance (median 7%), the difference in Systolic Blood Pressure - Heart Rate Product between rest and maximal exercise (delta PRP) (median 3%), and the time to onset of pain (median 10%); decreased nitroglycerin consumption (median 58%) and anginal attack rate (median 38%). Improvement in exercise tolerance was significantly correlated to an improvement in delta PRP (correlation coefficient = 0.7; p < 0.0001)but not to time of myocardial ischemia (correlation coefficient = 0.i;p = 0.1). Compared with 28 patients with a less pronounced anti-anginal effect, the 21 patients with a pronounced effect had a significant increase in local skin temperature, but had no significant change in distant skin temperature and pain thresholds. It is concluded that acupuncture, due to hemodynamic alterations, might have a specific effect on angina pectoris in addition to drug treatments.
BensonH.M. Angina pectoris and the placebo effect. N. Enal. J. Med. Vol. 300. 1424–1429. 1979.
2.
BallegaardS.PedersenF.PietersenA.NissenV.H.OlsenN.V. Effects of acupuncture in moderate, stable angina pectoris: A controlled study. J. Intern. Med. Vol. 227, 25–30, 1990.
3.
BallegaardS.MeyerC.N. Trojaborg, w. Acupuncture in angina pectoris: Does acupuncture have a specific effect? J. Intern. Med. Vol. 229, 357–362, 1991.
4.
BallegaardS.JensenG.PedersenF.NissenV.H. Acupuncture in severe, stable angina pectoris: A randomized trial. Acta Med. Scand. Vol. 220. 307–313, 1986.
MccrearyCTurnerJ. and DawsonE. The MMPI as a predictor of response to conservative treatment for low back pain. J. Clin. Psychol. Vol. 35(2). 278–284. 1979.
7.
LongC.J. The relationship between surgical outcome and MMPI profiles in chronic pain patients. J. Clin. Psychol. Vol. 37(4), 744–749, 1981.
8.
OostdamE.M. M and DuivenvoordenH.J. Predictability of the result of surgical intervention in patients with low back pain. J. Psychosom. Res. Vol. 27(4). 273–281. 1983.
9.
DziobaR.B. and DoxeyN.C. A prospective investigation into the orthopaedic and psychologic predictors of outcome of first lumbar surgery following industrial injury. Spine Vol. 9(6), 614–623, 1984.
10.
FinsetA. Familien og det sosiale netverket. JW. Cappelens Forlag, Oslo, 1981.
OmuraY. Normal and abnormal relationship between brain circulation estimated by supraorbital temperature measurements and grasping force of the corresponding hands: their clinical application for diagnosis and evaluation of various models of treatment. Acupunct. & Electro-Ther. Res. Int.J. Vol. 3. 49–96. 1978.
14.
XiaodingCShaofengX. & Wen-xiaoL. Inhibition of sympathetic nervous system by acupuncture. Acupunct. & Electro-Ther. Res. Int.J. Vol. 8, 25–35, 1983.
15.
AnderssonS.A.EricsonT.HolmgrenE.LindquistG. Electro-acupuncture. Effect on pain threshold measured with (Electrical stimulation of teeth. Brain Res. Vol. 63, 393–396, 1973.
16.
StacherG.WancuraI.BauerP.LahodaR. & SchulzeD. Effect of acupuncture on pain threshold and pain tolerance determined by electrical stimulation of the skin: A controlled study. Am. J. Chin. Med. Vol. 3, 143–149, 1975.
17.
OmuraY. Pain threshold measurement before and after acupuncture.: Controversial results of radiant heat method and electrical method, and the roles of ACTH-like substances and endorphins Acupunct. & Electro-Ther. Res. Int.J. Vol. 3. 1–21. 1978.
18.
NotermansS.L.H. Measurement of the pain threshold determined by electrical stimulation and its clinical application. Neurology. Vol. 16. 1071–1087. 1966.
19.
Beijinq Colleqe of Traditional Chinese Medicine. Essentials of Chinese Acupuncture. Beijing. Foreign Languages Press, 1980.
20.
KreimerS. Multidimensional contingency tables by exact conditional test. Scand. J. Stat. Vol. 14, 97–112, 1987.
21.
SiegelS. Nonparametric statistics for the behavioral sciences. McGraw, New York, 1956.
22.
BeyerW.H.Handbook of tables for probability and statistics. The chemical Rubber Co, Ohio. USA, 394. 1974.
23.
RosenthalR. Designing, analyzing, interpreting, and summarizing placebo studies. In: WhiteL.TurskyB. Schwartz. G. E, eds. Placebo. Theory. research and mechanisms. 110–136. Guildford Press, New York. 1985.
24.
Kaada. B. Placebo-gaten mot sin løsning? Tidsskr. Nor. Lægeforen. Vol. 106. 635–641. 1986.
25.
DahlstrømW.G.WelshG.S. and DahlstrømL.E.An MMPI handbook. Vol. 1, Clinical interpretations. A revised edition. University of Minnesota Press. Minneapolis, 1972.
26.
TavolaT.GalaCConteG. and InvernizziG. Traditional Chinese acupuncture in tension-type headache: a controlled study. Pain. Vol. 48, 325–329, 1992.
27.
WilliamsR. BHaneyT.I.McKinnisR.A. et al. Psychosocial and physical predictors of anginal pain relief with medical treatment. J. Psychosom. med. Vol. 48(3). 200 - 210. 1986.
28.
CottrauxJ.SchbathJ.MessyP.H.MollardE.JuenetC. and ColletL. Predictive value of MMPI scales on smoking cessation programs outcomes. Acta Psychiat. Vol. 86, 463–469, 1986.
29.
NielzenS.SjølundB.H. and ErikssonM.B.E. Psychiatric factors influencing the treatment of pain with peripheral conditioning stimulation. Pain Vol. 13, 365–371, 1982.
30.
ShafshakT.S.El-SheshaiA.M. & SoltanH.E. Personality traits in the mechanisms of interferential therapy for osteoarthritic knee pain. Arch. Phys. Med. Rehabil. Vol. 72, 579–581, 1991.
31.
WadeJ.B.DoughertyL.M.HartR.P. and CookD.B. Patterns of normal personality structure among chronic pain patients. Pain Vol. 48, 37–43, 1992.
32.
RubermanW.WeinblattE.GoldbergJ.D. and ChauidharyB.S. Psychosocial influences on mortality after myocardial infarction. N. Enal. J. Med. Vol. 311, 552–559. 1984.
33.
PayneB. and NorfleetM.A. Clinical Section: Review Article Chronic. Pain and the Family: A Review. Pain Vol. 26, 1–22, 1986.
34.
FontanaA.KernsR.D.RosenbergR.L. and ColonesesK.L. Support, stress, and recovery from coronary heart disease: A longitudinal causal model. Health Psychol. Vol. 82, 175–193, 1989.
35.
KaadaB. & EielsenO. In search of mediators of skin vasodilations induced by transcutaneous nerve stimulation. II. Serotonin implicated. Gen. Pharmacol. Vol. 14(6), 635–41, 1983b.
36.
LundebergT.ErikssonS.LundebergS. & ThomasM. Acupuncture and sensory thresholds. Am. J. Chin. Med. Vol. 17, 99–110, 1989.
37.
AnderssonS.A.EricsonT.HolmgrenE. and LindquistG. Analgesic effects of peripheral stimulation. General pain threshold effects on human teeth and a correlation to psychological factors. Acupunct. & Electro-Ther. Res. Int. J. vol. 2, 307–322, 1977.
38.
Von Graffenried B., Adler R., Apt K., Nuesch E. & Spiegel R. The influence of anxiety and pain sensitivity on experimental pain in man. Pain Vol. 4, 253–263. 1978.
39.
CornvallA. and DonderiD.C. The effect of experimentally induced anxiety on the experience of pressure pain. Pain Vol. 35, 105–113, 1988.
40.
JørumE. Analgesia or hyperanalgesia following stress correlates with emotional behavior in rats. Pain Vol. 32, 341–348, 1988.
41.
widerstrem - Noga E. Analaesic effect of somatic afferent stimulation - a psychobiological perspective (thesis). Vasastadens bokbinderi AB. Gøteborg, Sweden 1993.
42.
ZelmanD. CHowlandE. WNicholsS.N. & CleelandC.S. The effect of induced mood on laboratory pain. Pain Vol. 46, 105–111, 1991.
43.
WickramasekeraI. A conditioned response model of the placebo effect. Biofeedback Self-Regul. Vol. 5, 5–18, 1980.
WallP.D. The placebo effect: An unpopular topic. Pain vol. 51, 1–3, 1980.
46.
OmuraY. Patho-physiology of acupuncture treatment: effects of acupuncture on cardiovascular and nervous systems. Acupunct. & Electro-Theraputics. Res. Int. J. Vol. 1, 51–141, 1975.
47.
MannheimerCCarlssonC.A.EmanuelssonH.VedinA.WaagsteinF. and WilhelmssonC. The effects of transcutaneous electrical nerve stimulation in patients with severe anaina pectoris. Circulation Vol. 71, 308–316, 1985.
48.
KaadaB.Vik-moH.RoslandG.WoieL. & OpstadP.K. Transcutaneuos nerve stimulation in patients with coronary arterial desease: Haemodynamic and biochemical effects. Eur. Heart J. Vol. 11. 447–453. 1990.
49.
OmuraY. Non-invasive circulatory evaluation and electro-acupuncture and TES treatment of diseases difficult to treat in western medicine: 1) Abnormal brain circulation and blood pressure: Cephalic hypertension or cephalic hypotension syndromes and their related conditions -insomnnia, blindness due to macular degeneration & retinitis pigmentosa, and some psychiatric problems; 2) severe lower extremity circulatory disturbances, with intractable pain, intermittent claudication, ulceration and/or severe diabetic neuropathy. Acupunct. & Elect-Threr. Res. Int. J. Vol. 8. 177–256. 1983.
50.
SandersonJ.E.BrooksbyP.WaterhouseD.PalmerR.B.G. and NeubauerK. Epidural spinal electrical stimulation for severe angina: A study of its effects on symptoms, exercise tolerance and degree of ischemia. Eur. Heart J. Vol. 13. 628–633. 1992.
51.
RichterA.HerlitzJ. & HjalmarsonA. Effect of acupuncture in patients with angina pectoris. Eur. Heart J. Vol. 12, 175–178, 1991.
52.
RadzievskyS.A., Lebedeva, O.D., Fisenko, L.A. and Majskaja, S.A. Function of myocardial contraction and relaxation in essential hypertension in dynamics of acupuncture therapy. Am. J. Chin. Med. Vol. 17(4), 111–117, 1989.
